She rolls out of bed exhausted and reaches for that first cup of coffee to jumpstart another relentless day: getting the children up, fed and ready for school before rushing herself out the door. She grabs a few bites of unfinished toast, pushes through back-to-back meetings, survives on caffeine and whatever food is quickest, and ignores the growing feeling that she is struggling. By evening, she is still caring for everyone else – dinner, laundry, family needs – before collapsing into bed, and beginning the exhausting cycle all over again the next day.
This is a scenario I hear from women all the time when they finally admit they no longer feel like themselves: “Something is wrong…it has to be my hormones.”
I was there myself at 39, suddenly blindsided by anxiety, panic attacks and insomnia, despite always having slept easily before. What I needed to hear then, and what I want every woman reading this to understand, is that your body is not failing or malfunctioning. It is responding exactly as it was designed to during a major hormonal transition. This is perimenopause.
So What is Actually Happening?
Inside your body, a shift is happening – and it’s impacting the way you show up in your life. Unlike menopause, which is marked by a single day (the day after you’ve gone a full calendar year with no period), perimenopause is a journey of years – up to a full decade – generally starting in your forties, but not unlikely to begin in your mid-to-late 30s.
The journey is marked by declining progesterone and fluctuating estrogen. One of the first signs is a change in your menstrual cycle – irregularity. When you stop ovulating regularly, progesterone levels drop. Progesterone is calming – like nature’s Valium – so when it declines, you may notice anxiety, mood shifts and disrupted sleep. Meanwhile, estrogen is doing its own thing: declining, but going out with a louder bang. Like a roller coaster, it fluctuates wildly – sometimes spiking up to three times its normal level – which can make you feel fiery, irritable and all over the place.
The less visible symptoms – how you feel, your disrupted sleep, your exhaustion, your weight gain – are what often land a woman in her doctor’s office asking, “What’s wrong with me?” Bloodwork comes back normal, yet she feels anything but. It can feel like you have no control. I get it. But you actually have far more power here than you might realise.
There are three things every woman should know to help her navigate and thrive through this transition – and keep working on for the rest of her life. These aren’t trendy. They’re foundational. You can get on hormone support or spend heaps on supplements recommended by the latest influencer, but if you don’t have these three in check, everything will feel harder.
1. Pay Attention to Your Blood Sugar
As estrogen declines, so does your sensitivity to insulin – meaning your cells don’t respond as efficiently. When blood sugar isn’t stable, everything else becomes harder: managing your weight, keeping your energy and mood even, sleeping soundly and staying consistent.
One of the simplest tools I give clients is the PFF rule: eat Protein, Fat and Fibre with every meal – not just lunch and dinner, but breakfast especially. To your oatmeal and fruit bowl, add egg whites or a scoop of protein powder stirred in (protein), and a tablespoon of chia seeds or almond butter (fat). Those two additions change everything. Stable blood sugar means more energy, steadier mood, fewer cravings and better sleep. And it doesn’t begin and end with breakfast – your brain and body need consistent fuel throughout the day.
2. Protect Your Sleep Like Your Life Depends on It
Whether it’s an inability to fall asleep, waking at 1–4am and staring at the ceiling, or getting a few hours but waking unrefreshed, sleep disruption is one of the most common and debilitating parts of perimenopause. Declining hormones, unstable blood sugar and running warmer at night all play a role. My non-negotiable for clients: screens off at least one hour before bed. Artificial blue light tells your brain it’s still “go time”, suppressing melatonin in favour of cortisol.
But this pillar is really about adrenal health – something most women have never been told about. As your ovaries slow hormone production, your adrenal glands are supposed to take on a bigger role in making sex hormones post-menopause. The problem? Your adrenals have already been working overtime for decades managing every stressor you’ve faced – work pressure, family demands, sleepless nights, over-exercising, under-eating, all of it. They had your back every time. And now they’re being asked to take on an entirely new job as well.
It’s like a business taking on a major new project without hiring additional staff. The team is already stretched thin, yet suddenly expected to carry an even heavier workload with the same resources. No wonder you’re exhausted.
Protecting your adrenals means getting natural light into your eyes within 30 minutes of waking, keeping consistent sleep and wake times, managing blood sugar, giving yourself genuine time to rest and recover, and yes – screens off an hour before bed. You cannot pour from an empty cup.
3. Aim for Strong, Not Skinny
During the perimenopause transition, we lose a significant amount of muscle mass – up to 10%. After menopause, that loss continues at roughly 0.6–1% per year. Muscle is an organ of longevity and metabolic currency: when you lose it, you lose strength, bone density and glucose regulation, which compounds the weight management challenges you’re already experiencing.
I know the shift in body composition during this phase is deeply frustrating. But restricting calories, cutting carbs and pushing harder workouts may actually create more dysfunction, including thyroid disruption. There is a smarter way. Optimising your protein intake and building in regular resistance and weight training supports muscle maintenance, helps you build more lean mass going forward and makes weight management significantly easier. The goal isn’t to get smaller. It’s to get stronger and more resilient.
You Deserve to Be Heard
This isn’t a personal failing. It’s biology. And while two women might connect over the same surface symptoms – the weight gain, the sleeplessness, the zero patience, the one-glass-of-wine hangover – go deeper and you’ll find a unique experience. Every woman in this phase deserves to be heard and supported in the way her body is asking.
This is not “just ageing”. This is not something to push through alone or be told a holiday will fix. Your needs matter – and they shouldn’t fall to the bottom of your to-do list. You deserve a clinician who listens, validates your experience and understands hormonal health. If you leave an appointment feeling dismissed, it is okay to seek a second opinion. Hormone-literate support exists – and you are worth finding it.
